Individual
STACIE RENEE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
720 N BOND ST, SPRINGFIELD, IL 62702-4952
(217) 545-8000
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(217) 545-0253
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036-142803
IL
207YP0228X
Pediatric Otolaryngology Physician
036-142803
IL
Other
Enumeration date
07/09/2011
Last updated
02/12/2026
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